NPI | 1669738605 |
---|---|
Entity Type | Organization |
Authorized Contact | BERT A CHANCY Owner 229-794-3525 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
3336L0003X Pharmacy, Long Term Care Pharmacy | |
Enumeration Date | 2012-04-04 |
Last Update Date | 2012-04-04 |